“The needs of the patient come first” is a Mayo Clinic refrain, according to Eddie Greene, Director of Diversity in Education. Is there an opportunity to grow that patient-centered approach to leadership at other organizations? University of Utah Health Care CEO Vivian Lee and MetroHealth System CEO Akram Boutros weigh in.

What was really important was the questions that we asked our patients, which were about respect, about communication, about engagement in the decision-making process.”

“We can’t be a great medical center if our patients don’t think we’re great.” In response to these words from Lee’s predecessor, University of Utah began its patient satisfaction surveys in 2008. “What was really important was the questions that we asked our patients, which were about respect, about communication, about engagement in the decision-making process,” says Lee. She notes that initially, patient feedback was provided to physicians privately so that they could distill and determine how to respond to it themselves. “I really believe that set us on the journey to being a patient-centered organization,” Lee explains. “Because the questions that we asked were questions that our physicians helped us choose, and they weren’t about the food, they weren’t about things that the physicians couldn’t control. They were really about that relationship.”

“Physicians got onto this positive reinforcement situation where it just felt good to read good things about you from your patients, [and] the whole mindset of the organization just became so much more patient centered,” she adds. “And I think that’s the first step to this transformation.”

Everyone supports each other knowing that the patient is at the center, and if I watch you fail, that’s as much my fault as it is yours.”

“Physicians have an undue burden they place upon themselves, which is that they feel like they are the captain of the ship, they’re in charge of everything. We teach medical students: don’t trust anything unless you did it yourself,” says Boutros.

To lessen this burden at MetroHealth, they decided “to create the camaraderie that we talked about.” This started with the implementation of TeamSTEPPS, from the Agency for Healthcare Research and Quality, in a couple areas of the organization. The pilot worked well, according to Boutros, in providing psychological safety. “Within 11 months, we decided to become a training site,” he says. “And now, 3,600 or 3,700 of our 7,000 employees are trained in TeamSTEPPS. It’s organization wide, everyone supports each other knowing that the patient is at the center, and if I watch you fail, that’s as much my fault as it is yours.”

If envisioned and implemented properly, a partnership between clinical delivery systems and clinical research programs can get us closer to the goal of achieving learning within the care continuum and discovering evidence that is available when it is needed.

Clinician engagement is vital for improving clinical quality and patient satisfaction, as well as the job satisfaction of clinicians themselves. Yet nearly half of health care organizations are not very effective or not at all effective at clinician engagement.

The U.S. health care system may seem broken, but it’s on its way to greatness, according to the authors of Health Care Reboot. They discuss their optimism for U.S. health care reform, particularly on the social determinants of health, payment, consumerism, and technology.

NEJM Catalyst Insights Council members feel that culture change at their organizations is heading in the right direction, but differ on who it should come from, and reveal too much balance between emphasis on bottom line and emphasis on patient care.

Although three-quarters of Insights Council survey respondents say culture change is a high or moderate priority at their organizations, survey results show a lot of work on organizational culture remains to be done.